Introduction
John, who is 27 years old and has previous paramedic experience, has been exhibiting several symptoms that could be indicative of a mental health disorder. John has previously worked as a paramedic (Korgaonkar et al., 2023). To address these concerns, John has scheduled a medical appointment. It is becoming clear how much of an impact these symptoms, which have been present for three months, have on his life. John suffers from various symptoms, including intense nightmares, sleep problems, irritability, avoidance of social situations, intrusive memories, and increased alcohol consumption (Austin & Stein, 2019).
John’s symptoms’ severity and persistence over such a long period necessitate research into the potential causes of his mental health problems. This essay aims to comprehensively analyze John’s case, including a primary diagnosis, any co-occurring disorders, potential causes of his condition, and the unique challenges of treating the disorder(s) from a South African perspective. This will be written in the form of an essay for analysis. Mental health issues can be complex, and it is not always easy to pinpoint the underlying causes of a person’s current physical symptoms (Kowalchyk et al., 2023). Despite this, conducting a thorough investigation into John’s case may allow us to understand better the factors contributing to his condition’s development. The findings of this investigation may also aid medical professionals in developing more effective treatment plans to help John manage his symptoms and improve his overall quality of life. Because mental health issues are becoming more widely recognized worldwide, it is critical to investigate them from various cultural perspectives. As a result, from a South African perspective, this article will also look into the unique difficulties associated with managing the disorder or disorders discovered in John’s case. Understanding the influencing cultural factors is critical for effectively caring for and supporting those suffering from mental health issues (Kuester et al., 2017). Cultural factors can significantly influence how people perceive and treat mental health issues, so it is critical to understand this to provide adequate care and support. This essay aims to provide a comprehensive analysis of John’s case, focusing on the causes of his condition, potential diagnoses, and the difficulties associated with treating these disorders from a South African perspective. The primary goal of this essay is to provide an in-depth analysis of John’s case. With a better understanding of John’s condition, more effective treatment strategies could be developed to help him manage his symptoms and improve his overall quality of life. Increasing your understanding of John’s condition could help with this (Botha et al., 2019).
Primary Diagnosis
Based on his symptoms, the most likely diagnosis for John is Post-Traumatic Stress Disorder (also known as PTSD) (PTSD). In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, post-traumatic stress disorder (PTSD) is defined as a condition that develops in a person after they have either experienced or witnessed a traumatic event (Korgaonkar et al., 2023). Post-traumatic stress disorder is associated with various symptoms, including intrusive thoughts, avoidance behavior, unfavorable changes in mood and cognition, and changes in arousal and reactivity (PTSD). To be diagnosed with post-traumatic stress disorder (PTSD), a person must have symptoms that have lasted for more than a month and caused significant distress or impairment in social, occupational, or other critical areas of functioning. The individual must also meet the PTSD diagnostic criteria (Kedare Baliga & Kadiani, 2023).
According to the DSM-5 criteria, a person must have witnessed one or more traumatic events to be diagnosed with PTSD. These incidents could have involved sexual violence, serious injuries, or death, either actual or threatened (Kowalchyk et al., 2023). At least two negative cognition and mood changes, such as feeling cut off from others, holding unfavorable views of oneself, and persistently unfavorable emotional states, must occur, as well as at least two arousal and reactivity changes. Flashbacks, disturbing dreams, and intrusive memories are examples of intrusion symptoms. Attempts to avoid disturbing memories, thoughts, or feelings are examples of avoidance symptoms. To be diagnosed with post-traumatic stress disorder (PTSD), an individual must meet all of these criteria (e.g., hypervigilance, exaggerated startle response, irresponsible or self-destructive behavior) (Austin & Stein, 2019). Chronic fatigue syndrome is diagnosed when these symptoms last more than a month and significantly impair social, occupational, or other critical areas of functioning.
John has worked in a number of these specialized fields. According to the DSM-5 definition of traumatic event exposure, he was exposed to traumatic events while working as a paramedic. According to the DSM, exposure to a traumatic event perfectly fits this description of exposure. He considers intrusion symptoms to be familiar and expected (Korgaonkar et al., 2023). Intrusive memories and vivid nightmares are examples of these symptoms. He isolates himself from others, including his friends and fiancée, as one of his avoidance symptoms. He also experiences negative cognitive and mood changes, such as feelings of detachment and loss of interest in previously enjoyed activities. Finally, he exhibits changes in arousal and reactivity, such as increased vigilance and an exaggerated startle response. These changes indicate a shift in his anxiety level. These signs and symptoms are typical of hypervigilance, a condition (Kuester et al., 2017). These symptoms have been bothering him for at least three months and seriously affect his relationships, career, and personal life. These symptoms make it impossible for him to carry out everyday activities.
According to the ICD-10 criteria, the three significant clusters of symptoms that must be present to diagnose post-traumatic stress illness are re-experiencing, prevention, and hyperarousal (PTSD). The growth of post-traumatic stress ailment necessitates exposure to a traumatic event (Burke et al., 2019). If the symptoms cause clinically substantial anguish or deficiency in social, occupational, or other vital areas of functioning, this set of criteria must also be met.
John also meets all of the ICD-10 criteria for the PTSD diagnosis. He frequently has symptoms such as vivid nightmares and bothersome flashbacks. These warning signs have been present for quite some time. He isolates himself due to his avoidance disorder, which causes him to be socially isolated by withdrawing from other people and avoiding activities he used to enjoy. He exhibits hyperarousal symptoms such as increased vigilance and a heightened startle response (Korgaonkar et al., 2023). As a result of these symptoms, he is experiencing significant clinical distress, in addition to problems in his relationships, at work, and in his personal life.
John could suffer from alcoholism and post-traumatic stress disorder (PTSD) (AUD). The DSM-5 defines alcohol use disorder as having one or more of the following symptoms: impaired self-control, social impairment, risky behavior, tolerance, and withdrawal (AUD). John claims that he uses binge drinking to manage his symptoms, that he has missed work due to his binge drinking, and that cutting back on his intake is difficult for him. John also claims that his excessive drinking has caused him to miss work. These symptoms suggest that he may also suffer from an alcohol use disorder (AUD) (Kedare Baliga & Kadiani, 2023).
Overall, it appears that John meets the criteria for PTSD, and based on the information provided, he may also have comorbid AUD. It is critical to remember that to reach a definitive diagnosis, a qualified mental health professional must complete a thorough clinical evaluation. Before making a diagnosis, this step must be completed (Botha et al., 2019).
Comorbid Disorders
John may have an alcohol use disorder based on his symptoms and warning signs. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders terms alcohol usage illness as a form of knotty alcohol intake that causes significant impairment or distress (DSM-5). An alcoholic is someone who has a strong desire for alcohol. Aside from the loss of control, other symptoms include social impairment, risky use, tolerance, and withdrawal. The traumatic events associated with his paramedic work can be attributed to his alleged insomnia, irritability, social withdrawal, anhedonia, hyperarousal, and avoidance symptoms (Lewis et al., 2023). He also claims to have anhedonia. He has increased his alcohol consumption to cope with his symptoms, which has resulted in interpersonal issues at work and with the woman he is engaged to marry.
John meets the DSM-5 post-traumatic stress disorder diagnostic criteria (PTSD). This disorder describes John’s condition perfectly. Facing or observing concrete or defenseless demise, severe wound, or sexual violence is one of the most critical symptoms of post-traumatic stress disorder (PTSD) (Craighead et al., 2017). PTSD patients are more likely to experience hyperarousal, depressive changes in cognition and mood, intrusive reliving of the traumatic event, and avoidance of event-related stimuli. As a paramedic, John claims to have seen several “horrific” incidents. Due to his recurring nightmares and disturbing memories, he finds it challenging to discuss these incidents. Furthermore, he avoids seeing his former coworkers because it brings back negative memories of the time. Furthermore, he exhibits hyperarousal symptoms such as being easily startled and spending an inordinate amount of time searching for potential threats despite the lack of evidence that they exist (Howard et al., 2023).
As a comorbid condition, John’s alcohol use disorder (AUD) must be considered alongside his post-traumatic stress disorder (PTSD) (PTSD). A pattern of problematic alcohol consumption that causes clinically significant impairment or distress is a DSM-5 criterion for alcohol use disorder (AUD) (Lewis et al., 2023). This is one of the symptoms of alcoholism: (AUD). At least two of the eleven symptoms must be present, including tolerance, withdrawal, failed attempts to stop using, and continued use despite social or interpersonal problems. John claims that he has recently increased his alcohol consumption to deal with his troubling thoughts and inability to fall or stay asleep.
Furthermore, he claims that doing so has allowed him to sleep for more extended periods. John also claims that his drinking has caused interpersonal conflicts at work and with the woman he is engaged with. He has repeatedly failed to reduce his alcohol consumption, indicating that he has lost control of his drinking (Burke et al., 2019).
Consider whether John’s anhedonia and withdrawal from social situations are symptoms of depression. A person must exhibit at least five symptoms for at least two weeks before being diagnosed with major depressive disorder, according to the DSM-5. At least one instance of a depressed mood and a loss of interest or pleasure is required. Furthermore, each of these symptoms must be present simultaneously, and at least one must be present for the diagnosis to be made (MDD). To be diagnosed with major depressive disorder, you must also have a depressed demeanor, a diminished capacity for interest or pleasure, or both of these symptoms (Kedare, Baliga & Kadiani, 2023). John claims that he has become estranged from his fiancee and friends, is struggling to carry out his job responsibilities, and has lost interest in hobbies that he once enjoyed. On the other hand, these symptoms may result from a condition known as post-traumatic stress disorder (PTSD), and it is unclear whether or not they will persist after the PTSD that caused them has been treated.
John’s symptoms (F10.2) meet the ICD-10 diagnostic standards for alcohol use disorder (AUD) and post-traumatic stress disorder (F43.1) (F10.2). Post-traumatic stress disorder, as defined by the ICD-10 manual (PTSD), requires exposure to a traumatic event, signs of reliving the event, avoidance, increased arousal, and a minimum one-month duration of symptoms. The ICD-10 criteria for harmful alcohol use, which are equivalent to AUD under the DSM-5, require a pattern of alcohol use that has caused or is likely to cause physical or psychological harm, as well as a lack of control over drinking behavior for a diagnosis of harmful alcohol use. Howard and colleagues (2023).
According to the case study, John’s symptoms are consistent with PTSD, and may also have comorbid AUD. His symptoms, which include social withdrawal and apathy, could be caused by depression. This hypothesis is supported by the evidence (Austin & Stein, 2019). A comprehensive evaluation that considers the individual’s entire medical history is required to make an accurate diagnosis and develop an effective treatment plan that addresses all of the patient’s current symptoms. This evaluation is required for a diagnosis and the development of a treatment plan that addresses all of the patient’s current symptoms. During this evaluation, a thorough investigation into the individual’s previous substance use should also be conducted (Dean et al., 2023).
Aetiological Factors
John may have PTSD, also known as post-traumatic stress disorder, due to the incidents he witnessed while serving as a paramedic. This conclusion could be drawn based on John’s behavior. Some people develop post-traumatic stress disorder (PTSD) after observing or facing a traumatic happening, such as physical or sexual assault, or participating in combat (Lewis et al., 2023). Post-traumatic stress disorder (PTSD) is characterized by hallucinations, nightmares, or other intrusive memories of the traumatic event (PTSD). The following additional symptoms distinguish post-traumatic stress disorder, in addition to increased arousal and reactivity, mood and cognitive changes, and avoidance of traumatic memories: Craighead and colleagues (2017).
Gender influences the severity and timing of post-traumatic stress disorder symptoms (PTSD). According to research, women are far more prone than males to develop post-traumatic stress disorder (PTSD) after experiencing stressful experiences (Burke et al., 2019). Males, on the other hand, are more prone than females to experience traumatic occurrences, particularly those related to battle or those encountered by John while working as a paramedic (First et al., 2022). Women are more vulnerable to the traumatic impacts of natural disasters than men. Nonetheless, women are more likely than men to develop post-traumatic stress disorder (PTSD). Post-traumatic stress disorder (PTSD) may take longer to identify and treat since men are less likely than women to seek mental health care (Marlow et al., 2023).
Given that various factors could trigger John’s PTSD, this information is essential (PTSD). Past traumatic event exposure is one of the most critical peril causes for emerging post-traumatic stress disorder (PTSD). John’s exposure to numerous traumatic events as a paramedic most likely contributed to the onset of his symptoms. Individuals who are personally threatened or who have witnessed the danger of others are more likely to develop post-traumatic stress disorder (PTSD) (Kedare Baliga & Kadiani, 2023).
One of the essential factors in developing and maintaining PTSD is the availability of social support. Individuals with post-traumatic stress disorder are more likely to be isolated and to conflict with others (PTSD) frequently. John’s proclivity for isolation and estrangement from friends and family may have exacerbated his symptoms (Dean et al., 2023).
John’s reluctance to seek help and discuss his experiences may be influenced by the gender roles and expectations placed on men and women by society. Men are frequently socialized to be self-sufficient and unflappable, making it difficult for them to recognize and seek help for mental health problems. It is possible that John’s reluctance to seek help and his unwillingness to discuss his experiences in detail were influenced by contemporary societal norms (Craighead et al., 2017).
Finally, people with post-traumatic stress disorder frequently use alcohol as a coping mechanism (PTSD). Some people with post-traumatic stress disorder (PTSD) use alcohol to numb their emotions and help them sleep. Excessive alcohol consumption, on the other hand, can exacerbate PTSD symptoms and make treatment more difficult. John’s symptoms may worsen due to his increased alcohol consumption, and his recovery from addiction may be more difficult (Burke et al., 2019).
John has been diagnosed with post-traumatic stress disorder (PTSD), which his paramedic experiences may have caused. Finally, John’s symptoms are consistent with this diagnosis. Because John’s symptoms are consistent with a PTSD diagnosis, this could be the case. Alcohol consumption, exposure to traumatic events, gender-based social roles and expectations, social support, and interpersonal connections all contribute to developing and maintaining his symptoms (Botha et al., 2019). When working with people suffering from post-traumatic stress disorder (PTSD), mental health professionals must be aware of the abovementioned factors, especially men who may be reluctant to seek help. In addition to medication, talk therapy, and other forms of social support, it may be necessary to discuss gender roles and expectations to treat post-traumatic stress disorder (PTSD) (First et al., 2022).
Challenges associated with treating the specified disorder in South Africa
Because of South Africa’s apartheid history, managing mental health conditions such as alcohol use disorder and post-traumatic stress disorder can be extremely difficult. One of the most serious issues is a lack of mental health care services. According to a South African Depression and Anxiety Group study, only one out of every six people who need mental health care receive it, and most of those who do are white and middle-class (Dean et al., 2023). Those who are not white or from middle-class families appear to have significantly more difficulty obtaining mental health services than those from higher-income families.
The stigma associated with mental illness is another barrier South Africa must overcome. People are frequently discouraged from seeking treatment for their condition because they believe that having a mental health disorder shows weakness or inadequacy (Howard et al., 2023). This is a common misunderstanding. Even though mental illness is treatable, the stigma of mental illness can be especially pervasive in male-dominated fields such as emergency services, where a culture of toughness and resilience prevails (Dean et al., 2023). The military and law enforcement are two such examples. Admitting to having mental health problems is seen as a sign of weakness in today’s society, discouraging people from seeking help when they needed.
Another barrier in South Africa is the alarmingly high frequency of traumatic events and violent crimes. Many South Africans have experienced traumatic events due to political, interpersonal, or other forms of violence. Individuals may struggle to distinguish the symptoms of post-traumatic stress disorder (PTSD) from those of other mental health conditions or everyday stress, making PTSD diagnosis and treatment difficult. As a result, the disorder may be challenging to recognize and manage (Craighead et al., 2017).
Because of these challenges, South African mental health professionals must approach handling alcohol consumption ailment and post-traumatic stress disorder (PTSD) with sensitivity and cultural competence (Marlow et al., 2023). This could include educating people about the nature of these disorders, the importance of seeking treatment, and culturally appropriate treatment methods. This may also entail educating communities on the importance of seeking help. One way to accomplish this goal is to provide outreach and education to local communities (Botha et al., 2019).
Conclusion
Finally, John shows symptoms of post-traumatic stress disorder (PTSD), which frequently co-occurs with alcohol use disorder in trauma survivors. Even though treating these disorders presents unique challenges in South Africa, mental health professionals in the country must approach treatment with sensitivity and cultural awareness. Stigma exists, as does limited access to mental health services, and there is a high rate of violence and trauma. Despite these challenges, working with people affected by these disorders is critical. Mental health professionals in South Africa can help people with PTSD and alcohol use disorder achieve better outcomes by addressing the challenges posed by these conditions. John is currently suffering from both of these conditions.
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